Influence of diabetes on long‐term outcome among unselected patients with acute coronary events

Abstract

Objective—The aims of this study were to investigate the prognostic influence of diabetes after an episode of unstable angina pectoris or non‐Q‐wave myocardial infarction (MI) and to investigate whether diabetes is independently associated with increased short‐ and long‐term mortality risk following these episodes.

Design—Consecutive patients with a diagnosis of unstable angina pectoris or non‐Q‐wave MI, admitted to the Coronary Care Unit at Östra Hospital, Göteborg, Sweden during 1988–1998 were included. The primary endpoint was 2‐year mortality collected from the Swedish cause‐specific mortality register.

Results—The study included 4341 patients, 722 (17%) had diabetes. Diabetes was associated with increased mortality during initial hospitalization (10.2% vs 5.7%, p < 0.0001), after 30 days (13% vs 7.5%, p < 0.0001), and at 2 years (33.7% vs 20.2%, p < 0.0001). After adjustment for potentially confounding factors, diabetes remained an independent predictor of 2‐year mortality following unstable coronary syndromes, the hazard ratio (HR) of death (HR=1.6; 95% CI 1.4–1.9).

Conclusions—Among patients with unstable coronary syndromes, diabetes is an independent risk factor associated with increased mortality during hospitalization, short‐ and long‐term follow‐up.

• diabetes mellitus
• angina pectoris
• myocardial infarction
• prognosis